Postpartum body in the U.S.: diastasis assessment and non-surgical options

A few weeks after my second baby, I realized my core didn’t feel like “mine” yet. Jeans pinched in odd places, planks felt wobbly, and my belly sometimes made a little ridge when I sat up. I didn’t feel broken, just confused. Was this the infamous diastasis recti everyone whispered about in mom groups? I promised myself I’d learn the basics the way I would explain it to a friend—gently, clearly, and without scary stories or miracle claims. What follows is the diary I wish I’d had on hand, with practical steps for self-checks, what a professional assessment looks like in the U.S., and the non-surgical strategies that supported my recovery.

Why my belly still looked “a little pregnant” after delivery

In pregnancy, your abdominal wall adapts—beautifully—to make space. The connective tissue running down the center (the linea alba) gets thinner and the two sides of the rectus abdominis drift apart. That separation is called diastasis recti abdominis (DRA). It’s common, it varies widely, and it’s not a moral failing or a diagnosis of weakness. In the early postpartum weeks, some of that change naturally rebounds; some does not. What matters most isn’t just the width of the gap, but the quality of tension you can generate through the midline when you breathe, move, lift, and laugh.

When I reframed diastasis less as “a gap to close” and more as “a system to coordinate,” I stopped chasing quick fixes and started noticing how breath, pelvic floor, ribcage, and posture all talk to each other. My mood improved the same day I wrote that sentence in my journal.

What “diastasis” actually means for everyday function

Different bodies experience DRA differently. Some folks feel perfectly fine and return to running without issues; others notice doming along the midline, a tugging sensation above the navel, or back discomfort with long-standing chores. There’s also the pelvic floor—urinary leakage, pelvic heaviness, or a feeling of instability may come along for the ride. None of these automatically means danger, but they are useful clues as you plan a return to activity. I learned to track changes across ordinary tasks—getting out of bed, lifting a car seat, carrying groceries—rather than relying on a single mirror test.

A simple at-home check I could repeat safely

This is the low-tech, non-diagnostic check I used to gather clues. It doesn’t replace a professional evaluation, but it helped me move with more awareness:

• Set up: I lay on my back with knees bent and feet on the floor. I took a slow, easy inhale and then a gentle exhale.
• The feel test: Using two or three fingertips together, I pressed just below my sternum along the midline, then at the navel, then a couple of inches below the navel. While exhaling, I lifted my head and shoulders slightly—just enough to tense the abdominal wall—and noticed how many fingertips could fit between the muscle edges and, crucially, how the tissues pushed back. A “springy trampoline” feel suggested good tension; a “soft hammock” feel suggested less tension.
• Watch for doming or coning: If the midline bulged upward with effort, I noted the task that triggered it (sit-up style movements, coughing, lifting, or certain yoga poses).
• Symptom check: I wrote down whether anything came with pressure, pain, heaviness, or leakage. If yes, I dialed the activity down a notch and retested a day or two later.
• For authoritative context on postpartum activity safety, see ACOG’s guidance, which helped me understand timelines and the “start gentle, progress gradually” principle.

Two realities that kept me grounded: 1) some separation can be normal and compatible with strength, and 2) the body often improves over months with consistent, well-tolerated practice.

What a professional assessment looked like in the U.S.

When I booked with a pelvic health physical therapist, the session felt thorough and surprisingly encouraging. Here’s how it went, in broad strokes:

• History and goals: Birth details, symptoms (doming, back pain, heaviness), daily tasks I wanted to reclaim, and mental load. We set realistic milestones (e.g., “carry the stroller up stairs without a tuggy feeling”).
• Breath and pressure: We practiced a slow inhale into the ribcage and a soft exhale with gentle “corset” engagement. The therapist watched for rib flare, bearing down, or breath-holding during exertion.
• Abdominal wall: They assessed above, at, and below the navel for width and, again, tension. Ultrasound is sometimes used in clinics for more precise measurements; fingers are still common for practical checks.
• Pelvic floor screen: Depending on my comfort and consent, we screened for coordination (relax, contract, relax), not just maximal strength. (If an internal exam is offered, it should be explained clearly, and you can opt out.)
• Plan: We built a graded program—small daily work that fit nap windows and laundry rotations—plus cues I could use during childcare tasks (lift with exhale, avoid breath-holding, keep loads close).
• If you want to find a specialist in your area, directories like ChoosePT helped me understand the scope of physical therapy in the U.S. and locate pelvic-health providers.

Non-surgical strategies that respected healing

What worked best for me wasn’t flashy. It was a steady, evidence-informed routine, patient progression, and respect for sleep and stress (both of which change how tissues adapt). These were the anchors:

• Breath-led core training: Inhale softly; during exhale, imagine a gentle hugging of the lower belly (transverse abdominis) as if zipping up jeans—no bracing or clenching. Layer that onto simple movements like heel slides or wall sits.
• Pelvic floor coordination: First learn to fully relax; then coordinate a light “lift and gather” with exhale. Over-gripping made my symptoms worse, not better.
• Gradual load: I added challenge only when the previous level felt easy and symptom-free for a week or two. The rule was “progress without provoking.”
• Posture & daily mechanics: I practiced exhaling as I stood up with the baby, kept loads close to my body, and avoided hard breath-holds during effort. These tiny moments stacked up.
• External support: A soft binder or wrap felt comforting in the early weeks for some tasks. It didn’t “fix” the diastasis; it simply reminded my brain-body connection and reduced discomfort.
• Cardio within reason: Gentle walking or low-impact intervals boosted my mood and circulation, which helped recovery. Public health guidance (e.g., CDC’s recommendations for postpartum activity) reinforced that gradual movement is generally safe once cleared, adjusted to symptoms and delivery type.

Exercises I rotated through week by week

These aren’t prescriptions, just notes from my log with the progression logic. I stayed under the threshold of symptoms (no sharp pain, no persistent heaviness, no leakage). If a move triggered doming I couldn’t reduce with a lighter effort or better exhale, I swapped it out or regressed.

• Foundations (Days 7–42, as tolerated): 360° breathing (hands on ribs), heel slides, bent-knee fallouts, marching in place, supported side planks from knees, sit-to-stand with exhale. I thought of these as “communication drills” more than workouts.
• Early strength (Weeks 6–12): Dead bug progressions, bridges with mini-band, suitcase carries (light weight held at side) while exhaling through the step, farmer’s carry with light loads, tall-kneeling presses, modified planks where I could maintain midline tension.
• Return to impact (Months 3–6): Only after walking/jogging intervals felt steady and symptom-free did I add hops or run-walks. I increased one variable at a time (speed, distance, or frequency) and kept a log.
• Core challenges (Ongoing): Pallof presses, anti-rotation holds, side planks, cable rows with exhale, and eventually full planks/rollouts if I could prevent unmanaged doming.

Things I stopped doing for a while (then reintroduced thoughtfully)

Early on, I noticed that breath-holding during effort (hello, car seat lifting!) made my midline protest. I also paused long sets of full sit-ups, heavy twisting under fatigue, and advanced yoga transitions that demanded high intra-abdominal pressure I wasn’t yet coordinating. The pause was temporary, not punitive. When I came back to those moves, I used lighter loads, fewer reps, and better breath timing.

Progress cues I tracked instead of just “the gap”

• Tension quality: Did my linea alba feel springy and supportive during gentle head lifts and daily tasks?
• Symptom trend: Less doming, less tugging, steadier back after standing? Fewer “oops” leaks when I sneezed?
• Capacity: Could I carry a fussy baby for longer without bracing? Could I do groceries in one trip while breathing smoothly?
• Confidence: Did I feel more at home in my body—less fearful, more curious?

Signals that told me to slow down and double-check

None of this is about perfection. It’s about paying attention. If I noticed these, I took a step back or called my clinician:

• Red flags: New or worsening abdominal pain, a visible bulge that didn’t reduce when lying down (possible hernia), vaginal bleeding that increased after activity, fever or signs of infection, chest pain or shortness of breath, severe headache, or any “something isn’t right” gut feeling. See the CDC’s list of urgent postpartum warning signs for a clear, plain-language overview: CDC Hear Her.
• Pelvic floor strain: Persistent heaviness/pressure in the pelvis, leakage that didn’t improve, or pelvic pain during basic tasks. That’s my cue for professional help.
• Training response: If a new exercise left me feeling unstable for the rest of the day, I marked it and scaled back.

What I’m keeping and what I’m letting go

The biggest mental shift for me was trading perfection for presence. I’m keeping three principles:

• Coordinate first, then load: Breath and pressure strategies before adding weight or impact.
• Progress by feel, not by a calendar: My body’s signals outweigh arbitrary timelines.
• Function over aesthetics: A strong, responsive midline beats a textbook measurement.

And I’m letting go of the idea that healing is linear or that a persistent separation automatically equals dysfunction. Many people live, lift, and play symptom-free with a small gap, as long as tension and coordination are solid. For personalized counsel, I found it helpful to combine trustworthy national guidance with local, hands-on evaluation.

FAQ

1) How do I know if I really have diastasis recti?
Answer: A simple self-check (fingertips along the midline during a gentle head lift) can give clues about width and tension, but it’s not a diagnosis. If you’re unsure—or symptoms bother you—see a clinician or a pelvic health PT for a full evaluation.

2) Do I need surgery if my gap doesn’t “close”?
Answer: Not necessarily. Many people regain excellent function without surgery, even with some visible separation. Surgery is usually reserved for significant symptoms (e.g., hernia, functional limitations) after a thorough non-surgical trial and shared decision-making with your care team.

3) Are abdominal binders good or bad?
Answer: They can be comfort tools in the early weeks, helping you feel supported during certain tasks. They don’t “fix” diastasis by themselves. If a binder lets you move more comfortably while you build coordination and strength, that can be helpful.

4) When can I run again?
Answer: It depends on symptoms and capacity, not the calendar. Many start testing run-walk intervals a few months postpartum after walking feels easy, pelvic floor symptoms are quiet, and midline tension holds during low-impact hops. A gradual, symptom-led progression is safer than a hard deadline.

5) What if I had a C-section?
Answer: You can still train breath, posture, and gentle core coordination once cleared by your clinician. Scar care, pain levels, and energy may change your pace. A pelvic health PT can tailor progressions and positions to keep things comfortable and effective.

Sources & References

• ACOG — Exercise After Pregnancy
• CDC — Urgent Postpartum Warning Signs
• MedlinePlus — Postpartum Care
• Cleveland Clinic — Diastasis Recti
• APTA — ChoosePT (Find a Physical Therapist)

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).